| NPI | 1144511700 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME45122) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL ME0045122) |
| Enumeration Date | 2011-04-29 |
| Last Update Date | 2013-03-04 |